Meaningful Use.. Glasses after Cataracts with Medicare

It has been awhile since I blogged , I was getting my office set for meaningful use. It was a bumpy, expensive and educational ride but we started our 90 days on October 2 in the cloud with Officemate and Examwriter. I also happy to report my office remodel is now complete. 

MOA news... Dr Fran Burgos has taken over as our Education Chair and we welcomed him to our last board meeting, also The Maryland Public Health association has approved our application for new Eye and Vision Care section in their association. 

Below is some interesting news from the AOA.  I find it interesting now that we have to pay over $500 for the privilege  of supplying glasses to our post cataract patient who have medicare. 

Talk soon 

John.

Reminder: Optometrists subject to $500+ fee for Medicare DMEPOS enrollment

Optometrists who wish to provide eyeglasses for cataract patients under Medicare are subject to a new durable medical equipment prosthetics, orthotics and supplies (DMEPOS) registration fee every three years, according to the AOA Advocacy Group.  As reported in AOA publications previously, the fee was put in place in March 2011 over the objections of AOA and other physician organizations when the Centers for Medicare & Medicaid Services (CMS) decided to treat all DMEPOS suppliers as institutional fraud risks.

Under a government initiative to screen out unscrupulous providers, all physicians who are now enrolled as health care practitioners or suppliers under Medicare will be required to re-enroll by March, 2015.   Optometrists should watch for letters to revalidate their Medicare enrollment, which verifies their enrollment records in the government health plan’s Provider Enrollment, Chain and Ownership System (PECOS).

Optometrists and other health care physicians who wish to provide only professional services are not subject to any Medicare registration fees, the AOA Advocacy Group notes. However, those who wish to provide health care products, including eyeglasses, are subject to a new $500+ fee ($523 this year, indexed to increase annually with inflation) as well as stringent new screening requirements including site visits by inspectors.

The Medicare DMEPOS registration fee is distinct from the health plan’s DMEPOS provider surely bond requirement, from which optometrists have been exempted unless they provide eyeglasses to the public without any sort of examination of the patient, and separate from the DMEPOS accreditation requirement, until the CMS decides to implement supplier standards for physicians.

The AOA Advocacy Group has been lobbying to win exemption for optometrists from the DMEPOS registration fee as well. However, at this time, the registration fee remains applicable to eyewear providers and other physicians who furnish DMEPOS to their patients, AOA Advocacy Group staff note.

Many optometrists have been receiving notifications to reenroll in Medicare over recent weeks, the AOA Advocacy Group reports.

For additional information, see “HHS anti-fraud program to mean new scrutiny, fees for physicians" on the AOA Newsblog or the Medicare Learning Network (MLN) article “Further Details on the Revalidation of Provider Enrollment Information."

Transformations

As I tried to celebrate the end of summer, I went to Ocean City with my family and unfortunately Mother Nature had other plans. Upon hitting the beach we discovered the flies were all over us. Locals blamed the wind coming off the bay. We retreated inside and I stumbled upon a TV show called “Bar Rescue” where they take a bar in danger of closing and transform it into a successful one.

In each episode the theme of the bar/restaurant was modified to adapt to environmental changes, which had not been accounted for or addressed by the owner.  Of course this brought about apprehension from the staff and owners, and as with all reality TV there was plenty of drama, but if you looked at the end result it was simply amazing.  Watching these transformations unfold made me think about change and how it relates to success.  Change is never easy.  It usually involves a lot of hard work to overcome obstacles that stand in the way.  This said, almost all success stories depend upon change to some extent.

Reflecting back on my first nine months as President I began to think about the transformation going on in the MOA.  We hired an expert (Dr. Jim Caldwell) to help us develop a strategic plan. Realizing that public health and legislative policy goals would be important moving forward, we hired a Director of Legislative Affairs, Jennifer Levy. Jennifer’s years of experience in Annapolis have greatly assisted us in achieving goals outlined in our new strategic plan.  Like the bars and restaurants I watched on TV, the MOA transformation has been slow and not without some obstacles, even hesitation.  However, the successes we have seen and those we anticipate as a result of changes the MOA has instituted thus far are real and exciting.  We are becoming well known in Annapolis and within the national and State public health community. We have even been recognized nationally by the AOA as a result of optometry’s victory with a Maryland ERISA plan offered by Shore Health Systems on the Eastern Shore.   Jennifer has set up a wonderful legislative section on the MOA website. The section is packed with information about the practice of optometry in Maryland and information about state and national policy agendas that impact us.  Check it out and use it as a resource by visiting the MOA website at http://maryland.aoa.org/x13892.xml. Please read our Legislative update for news on our Mission 2020 Campaign.

I would like to congratulate the following award recipients for 2012 who will be recognized during our convention at the annual meeting and luncheon on Sunday, December 2:
            Optometrist of the Year - Dr. Lamont Bunyon
            Young Optometrist of the Year - Dr. Kevin Johnson
            Mel Waxman Award (distinguished service) - Dr. Jim Eickhoff
            Eugene McCrary Award – Ms. Margaret Hayes - Maryland Public Health Association

I would like to thank Dr. William Davis for years of dedicated service to MOA as Education Chairman.  He and his family will be moving out of state shortly. I did receive some interest on this position last month, but we could use additional volunteers and committee members.  If you are interested, please contact the MOA office at moa@assnhqtrs.com.  William did a remarkable job in landing nationally known speakers Drs. Ben Gaddie and Paul Karpecki for our convention this December.

During our last board meeting, I was quite shocked to learn that we lost over 30 members last year. Obviously this cannot continue. We need every licensed optometrist to be a member so we can continue to make advances for optometry in this state.  If you are not a member, please join the association, and we have a referral program to get colleagues to join with you.

Please join us when we call upon you to help us in transforming MOA’s theme and securing optometry’s future in Maryland. I think the ROI at the end of our show will be huge, but our success depends on everyone working together. If Buck Showalter can do it with the Orioles, we can do it with the MOA.

As for Bar Rescue, I may not watch it again until the next time inclement weather traps me indoors, but I do plan on going to Murphy’s Law in Fell’s Point during our December convention.  Consider joining me there to see a true success story and tell me what you think our success story should look like.

AOA at work

AOA and State Affiliates Pressure Medicare Contractor to Withdraw Restrictive Policy

Facing intense pressure from AOA, state affiliates and pro-optometry leaders in Congress, a Medicare Administrative Contractor (MAC) reversed course on Monday and announced that it would withdraw a restrictive, anti-optometry coverage directive which wrongly sought to limit the scope of practice of optometrists in nine states.

Wisconsin Physician Services (WPS) — the MAC servicing Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska and Wisconsin — had issued an “optometry services” coverage determination whereby the contractor created a list of services it determined optometrists are allowed to provide based on its own flawed interpretation of state law. With backing from a Medicare regional office, WPS then utilized the directive to deny payment for services provided to Medicare beneficiaries which optometrists are legally authorized to perform.

Working closely with affected state affiliate volunteer leaders and staff, AOA appealed to pro-optometry lawmakers to help make clear to federal agency officials that states — not Medicare contactors —determine optometrists’ scope of practice. AOA and affiliates secured supportive letters from U.S. Senators Roberts (R-KS) and Moran (R-KS), and Reps. Braley (D-IA), Loebsack (D-IA), Boswell (D-IA), Latham (R-IA), King (R-IA), Huelskamp (R-KS), Jenkins (R-KS), Yoder (R-KS), Pompeo (R-KS), and Burgess, MD (R-TX).

After building support on Capitol Hill, AOA and affiliates then met with top Center for Medicare and Medicaid Services (CMS) officials at the agency’s headquarters in Washington, D.C. With pressure generated through lawmaker outreach and the productive meeting with CMS leaders, the Medicare contractor had to abandon its “optometry services” coverage determination, the precise action which AOA Federal Relations Committee chair, Roger Jordan, O.D., and state affiliate leaders had been seeking.

AOA and affiliates will remain vigilant to ensure that any future policy developed by the contractor respects optometry and the right of Medicare beneficiaries to receive eye care through their optometrist. To view the full report from AOA, please follow :http://newsfromaoa.org/2012/10/03/aoa-state-affiliates-pressure-medicare-contractor-to-withdraw-restrictive-policy/